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Part of Coverage and benefits

Coverage for Seniors Program

Premium-free coverage for prescriptions drugs and other health-related services not covered under the Alberta Health Care Insurance Plan.

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October 1, 2026 changes

Beginning October 1, 2026, changes to the Alberta Health Care Insurance Act (Bill 11) require employer-sponsored drug and supplemental benefit plans to maintain drug coverage for employees 65 years and older who are actively employed. Additionally, changes to insurance coverage will be in effect. It changes which plan pays first: where private or other coverage is available, it pays first, and government-sponsored coverage acts as the safety net. No eligible Albertan will lose access to government-sponsored drug coverage because of this change. For more information, see the Coordination of benefits section below.

Overview

The Government of Alberta provides seniors with premium-free coverage for prescriptions drugs and other health-related services not covered under the Alberta Health Care Insurance Plan (AHCIP).

  • Alberta Blue Cross administers the Coverage for Seniors program and claims.
  • AHCIP manages eligibility and registration.

The Coverage for Seniors program does not include travel insurance.

If you are planning to travel outside of the province or country, you are advised to purchase travel insurance to cover emergency hospital and medical expenses.

Eligibility

To be eligible for Coverage for Seniors, you need to have active AHCIP coverage and have had your age validated.

When AHCIP records indicate an Albertan will be turning 65, a package is mailed to the address on their AHCIP file that includes information about programs and services for seniors.

  • If your age has not been validated, this package will be mailed up to 6 months prior to your 65th birthday and include a letter asking you to submit a proof-of-age document.
  • If your age has been validated, the package is mailed up to 3 months before your 65th birthday and Coverage for Seniors is automatically added to your AHCIP account on the first of the month following your 65th birthday, or on the first if your birthday is on the first.
  • If you did not receive the package, we may not have your current address on file. You can download a Proof-of-Age Declaration form or contact the AHCIP office.

Acceptable proof-of-age documents include:

  • Alberta driver’s licence
  • Alberta identification (ID) card
  • birth certificate
  • old-age pension entitlement form
  • passport or immigration record
  • Canadian citizenship certificate

Your proof-of-age document and declaration can be submitted by one of the following:

Benefits provided

  • Prescription drugs

    Prescription drugs listed in the Alberta Drug Benefit List are covered. The co-payment is 30% to a maximum of $35, effective April 1, 2026. A co-payment is the portion of the prescription cost you pay to your pharmacy when you have your prescription filled. For most prescriptions, you will not pay more than the co-payment maximum for each prescription.

    There are a few cases when you might have to pay more than the co-payment maximum.

    • If your drug is not listed in the Alberta Drug Benefit List.
    • If you want a more expensive brand of drug than the least cost alternative or generic product.
    • If the brand of drug you want costs more than the maximum cost set by the Alberta government for that drug.

    To avoid surprises, ask your pharmacist about the cost of your prescription before it is filled.

  • Diabetes supplies

    Plan members with diabetes will receive coverage for diabetes supplies purchased from a licensed pharmacy, up to a maximum of $2,400 per eligible person depending on the method of diabetes management. (Read the Coverage Maximums for Diabetes Supplies fact sheet). This benefit will be for each benefit year, that is, July 1 to June 30. Eligible diabetes supplies include test strips, needles, syringes, and lancets. There is no co-payment for eligible diabetes supplies.

    Continuous Glucose Monitors (CGMs) are available to Albertans living with diabetes who meet certain eligibility criteria. See the CGM Fact Sheet for more information about CGM coverage and eligibility criteria. Co-payments apply to CGMs and these devices are not included in the annual maximum for diabetes supplies.

    The use of a CGM reduces or eliminates the need for blood glucose test strips. Albertans who receive funding for a CGM will have adjusted limits for blood glucose test strips, which will still provide for occasional use. Albertans who do not receive funding for a CGM will continue to have the same limits for blood glucose test strips. See the Coverage Maximums for Diabetes Supplies fact sheet for more information.

    If you are a low-income senior, learn about Special Needs Assistance for Seniors, if you have reached your diabetes supplies limit for the benefit year.

  • Ambulance services

    Seniors, age 65 and over, enrolled in the Coverage for Seniors program do not receive a bill for ambulance services. AHCIP pays the complete cost of ambulance services.

    Ambulance services are covered to the maximum rate established by the Alberta government for treatment, and transportation to and from a general, active treatment hospital in the event of illness or injury.

    Transportation must be provided in a ground vehicle approved under the Emergency Health Services Act and regulations. It does not include interfacility transfer by ambulance.

  • Clinical psychological services

    Coverage for clinical psychological services are up to $60 per visit, to a maximum of $300 per family each benefit year for treatment of mental or emotional illness by a registered chartered psychologist.

  • Home nursing care

    Coverage for home nursing care is up to $200 per family each benefit year for nursing care provided in the patient's home by written order of a physician. Home nursing care must be provided by a registered nurse or licensed practical nurse who is not a relative of the patient.

  • Chiropractic services

    Coverage for chiropractic services is up to $25 per visit to a maximum of $200 per person each benefit year.

What is not covered

The following are not covered under the Coverage for Seniors program:

  • claims for benefit expenses incurred prior to the effective date of coverage
  • claims for benefit expenses received by Alberta Blue Cross more than 12 months after the service was provided
  • services covered by the AHCIP
  • charges for drugs supplied directly and charged for by a physician, with the exception of allergy serums
  • registration, admission or user fees charged by a hospital
  • drug products not listed in the Alberta Drug Benefit List – ask your pharmacist or physician if your prescribed medication is on this list
  • semi-private or private hospital room
  • travel insurance for emergency hospital and medical expenses outside of the province or country

Coordination of benefits

Alberta’s government-sponsored drug and supplemental health benefits plans are legislated as payor of last resort. For Albertans who have private or employer sponsored coverage, benefits are coordinated between their private or employer sponsored plans and applicable government-sponsored health benefit programs. This coordination helps ensure individuals receive the coverage they are eligible for under both plans.

Changes for Albertans

Albertans are required to inform their pharmacy about all drug and supplemental health benefit coverage that they may have, so that the pharmacist is able to coordinate all benefits at the point of dispensing. If an Albertan has private or employer sponsored drug and supplemental health benefit plan, this plan will be required to pay first, and government-sponsored plans will cover the remaining portion for eligible drug benefits. If private plan benefits are unavailable or exhausted, the Albertan’s government sponsored drug and supplemental benefit plan will continue to cover eligible drugs and supplemental benefits in accordance with existing program rules.

Government-sponsored drug and supplemental benefits plans will continue to act as a safety net, providing drug and supplemental benefits coverage for any Albertan who requires access to drug and supplemental benefits. This legislation will help to ensure long-term financial sustainability of government programs, ensuring that those who are most vulnerable will have access to drug and supplemental health benefits coverage when no other option is available.

Contact

Connect with Alberta Blue Cross.

Related

Previous Non-Group Coverage